Abstract：
Up to 30% of patients referred to epilepsy centres for drug-resistant epilepsy turn out to have psychogenic nonepileptic seizures (PNES). Patients with PNES are a very heterogeneous population with large differences in regard to underlying causes, seizures severity, and impact on quality of life. There is limited knowledge regarding the long-term seizure prognosis of youth with PNES and its influential factors.
We have performed a retrospective study on adolescents diagnosed with PNES who were receiving inpatient care at our hospital for 2-4 weeks in the period of 2012-2020. They all attended psychoeducational courses to educate them about PNES, coping with the seizures, and possible contributors to seizure susceptibility. There were 258 patients who fulfilled the inclusion criteria. We contacted them by text messages, through which they received brief information about the study and an invitation to participate. There were 62 patients (24 %) who agreed and participated in structured telephone interviews. We excluded 10 patients due to concomitant epilepsy. The mean age of the remaining 52 participants was 20.9 years (16-28 years), and 45 (87 %) were women.
After a mean of 4.7 years (2-9 years) since discharge from our hospital, 28 patients (54 %) had been free of seizures in the last 6 months. There were 16 patients (31 %) who had better situations in regard to seizures but were not completely seizure free, while 8 patients (15 %) were either unchanged (3 patients) or worse (5 patients). There were 39 patients (75 %) who had received conversation therapy, and 37 patients (71 %) had been treated by a psychologist or psychiatrist. There were 10 patients (19 %) who had dropped out of school or work, and the percentage increased with age. There were 42 patients (80 %) who perceived their health as good or very good.
Patients had a relatively favourable seizure prognosis as 54% were free of seizures and 31% had a better seizure situation, at the time of this study. However, the fact that 19% had dropped out of school or work was worrying. Young age and satisfaction with treatment were associated with being employed or receiving education. Satisfaction with perceived treatment was significantly associated with personal experience of good health. This emphasizes the importance of early diagnosis, adapted interventional measures, and long-term follow-up by healthcare for young people with PNES.
We have performed a retrospective study on adolescents diagnosed with PNES who were receiving inpatient care at our hospital for 2-4 weeks in the period of 2012-2020. They all attended psychoeducational courses to educate them about PNES, coping with the seizures, and possible contributors to seizure susceptibility. There were 258 patients who fulfilled the inclusion criteria. We contacted them by text messages, through which they received brief information about the study and an invitation to participate. There were 62 patients (24 %) who agreed and participated in structured telephone interviews. We excluded 10 patients due to concomitant epilepsy. The mean age of the remaining 52 participants was 20.9 years (16-28 years), and 45 (87 %) were women.
After a mean of 4.7 years (2-9 years) since discharge from our hospital, 28 patients (54 %) had been free of seizures in the last 6 months. There were 16 patients (31 %) who had better situations in regard to seizures but were not completely seizure free, while 8 patients (15 %) were either unchanged (3 patients) or worse (5 patients). There were 39 patients (75 %) who had received conversation therapy, and 37 patients (71 %) had been treated by a psychologist or psychiatrist. There were 10 patients (19 %) who had dropped out of school or work, and the percentage increased with age. There were 42 patients (80 %) who perceived their health as good or very good.
Patients had a relatively favourable seizure prognosis as 54% were free of seizures and 31% had a better seizure situation, at the time of this study. However, the fact that 19% had dropped out of school or work was worrying. Young age and satisfaction with treatment were associated with being employed or receiving education. Satisfaction with perceived treatment was significantly associated with personal experience of good health. This emphasizes the importance of early diagnosis, adapted interventional measures, and long-term follow-up by healthcare for young people with PNES.
摘要：
背景：多达30％的患者转诊到癫痫中心治疗耐药癫痫，结果是有心理性的非癫痫发作（PNES）。PNES患者是一个非常异质的人群，在潜在原因方面存在很大差异，癫痫发作的严重程度，以及对生活质量的影响。关于PNES青年的长期癫痫发作预后及其影响因素的知识有限。
方法：我们对2012-2020年期间在我院接受2-4周住院护理的被诊断为PNES的青少年进行了回顾性研究。他们都参加了心理教育课程，对他们进行有关PNES的教育，应对癫痫发作，以及癫痫发作易感性的可能贡献者。258例患者符合纳入标准。我们通过短信联系了他们，他们收到了关于这项研究的简短信息，并邀请他们参加。有62名患者（24％）同意并参加了结构化电话采访。我们排除了10例并发癫痫患者。其余52名参与者的平均年龄为20.9岁（16-28岁），45名(87%)是女性。
结果：自出院以来平均4.7年（2-9年）后，28名患者（54％）在过去6个月中没有癫痫发作。有16名患者（31％）有更好的情况下，癫痫发作，但不是完全没有癫痫发作，而8例患者（15％）未改变（3例）或恶化（5例）。有39名患者（75％）接受过对话疗法，37名患者(71%)接受过心理学家或精神科医生的治疗。有10名患者（19％）辍学或工作，百分比随着年龄的增长而增加。有42名患者（80％）认为自己的健康状况良好或非常好。
结论：患者的癫痫发作预后相对良好，因为54％的患者没有癫痫发作，31％的患者癫痫发作情况更好，在这项研究的时候。然而,19%的人辍学或工作的事实令人担忧。年轻的年龄和对治疗的满意度与被雇用或接受教育有关。对感知治疗的满意度与个人健康体验显着相关。这强调了早期诊断的重要性，适应的介入措施，以及对患有PNES的年轻人进行医疗保健的长期随访。
方法：我们对2012-2020年期间在我院接受2-4周住院护理的被诊断为PNES的青少年进行了回顾性研究。他们都参加了心理教育课程，对他们进行有关PNES的教育，应对癫痫发作，以及癫痫发作易感性的可能贡献者。258例患者符合纳入标准。我们通过短信联系了他们，他们收到了关于这项研究的简短信息，并邀请他们参加。有62名患者（24％）同意并参加了结构化电话采访。我们排除了10例并发癫痫患者。其余52名参与者的平均年龄为20.9岁（16-28岁），45名(87%)是女性。
结果：自出院以来平均4.7年（2-9年）后，28名患者（54％）在过去6个月中没有癫痫发作。有16名患者（31％）有更好的情况下，癫痫发作，但不是完全没有癫痫发作，而8例患者（15％）未改变（3例）或恶化（5例）。有39名患者（75％）接受过对话疗法，37名患者(71%)接受过心理学家或精神科医生的治疗。有10名患者（19％）辍学或工作，百分比随着年龄的增长而增加。有42名患者（80％）认为自己的健康状况良好或非常好。
结论：患者的癫痫发作预后相对良好，因为54％的患者没有癫痫发作，31％的患者癫痫发作情况更好，在这项研究的时候。然而,19%的人辍学或工作的事实令人担忧。年轻的年龄和对治疗的满意度与被雇用或接受教育有关。对感知治疗的满意度与个人健康体验显着相关。这强调了早期诊断的重要性，适应的介入措施，以及对患有PNES的年轻人进行医疗保健的长期随访。
